internal assessment-II paper - 1

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CARDIOLOGY(C)

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 A1.   Evolution of symptomatology and event timeline -  Past- 10yrs ago - Operation for Hernia Since 2-3 yrs - Facial puffiness 1 yr ago - SOB grade II 1 yr ago - was diagnosed with Hypertension. When the patient came to OPD -  Since 2 days - SOB which progressed from Grade II to Grade IV. Since 2 days - Decreased urine output. Since 1 day - Anuria After admission -  CT scan - Showed dilated pulmonary vessels and thrombi in the atria. 2D Echo - Showed LV dysfunction. Anatomical location - Atria (SA node) A2. Digoxin - It is a cardiac glycoside              MOA - It increases intracellular sodium that will cause an influx of calcium in the heart and cause an                     increase in contractility. It is vagomimetic.               Indications - Heart failure and arrhythmias.           Carvediol - It...
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GASTROENTEROLOGY(B)

  A1. ·          The cause of pancreatitis in this case can be attributed to ALCOHOL.                                                            In acute pancreatitis                                                                  ↓                           Premature activation of zymogen granules in pancreas                                 ...
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INFECTIOUS AND HEPATOLOGY(A)

 A1. Locally made alcohol is not prepared under asegtic conditions ,it could be bacterially contaminated. This could have lead to liver abscess in this patient. A2. Most likely this is due to the unhygienic practices commonly seen at the drinking taverns or cottages in many tropical countries. The important finding observed in most of the studies is that majority of ALA patients are from a poor socioeconomic background and are manual laborers . Poor hygiene has been associated with increased risk of amoebic liver abscesses and is directly proportionate to disease progression and extent of liver injury Parasite cysts are transmitted through contaminated food and water, making the incidence of disease high in areas of poor sanitation.  asymptomatic intestinal amoebiasis is also common ethanol could influence several factors to make individuals infected with amoeba to develop extraintestinal invasion.  Alcohol has a significant influence on both cell-mediated and humoral i...
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